| National Provider Identifier [NPI]: | 1144661539 |
| Last Name Of The Provider | PRICE |
| First Name Of The Provider | MARK |
| Middle Initial Of The Provider | M |
| Credentials Of The Provider | FNP |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1701 50TH ST |
| Street Address 2 Of The Provider | |
| City Of The Provider | LUBBOCK |
| Zip Code Of The Provider | 794122701 |
| State Code Of The Provider | TX |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Nurse Practitioner |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 66 |
| Number Of Services | 861 |
| Number Of Medicare Beneficiaries | 150 |
| Total Submitted Charge Amount | 46487.01 |
| Total Medicare Allowed Amount | 19410.81 |
| Total Medicare Payment Amount | 12995.53 |
| Total Medicare Standardized Payment Amount | 16945.7 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 15 |
| Number Of Drug Services | 392 |
| Number Of Medicare Beneficiaries With Drug Services | 71 |
| Total Drug Submitted ChargeAmount | 5611.01 |
| Total Drug Medicare AllowedAmount | 543.81 |
| Total Drug Medicare PaymentAmount | 408.73 |
| Total Drug Medicare Standardized Payment Amount | 408.73 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 51 |
| Number Of Medical Services | 469 |
| Number Of Medicare Beneficiaries With Medical Services | 150 |
| Total Medical Submitted Charge Amount | 40876 |
| Total Medical Medicare Allowed Amount | 18867 |
| Total Medical Medicare Payment Amount | 12586.8 |
| Total Medical Medicare Standardized Payment Amount | 16536.97 |
| Average Age Of Beneficiaries | 60 |
| Number Of Beneficiaries Age Less65 | 77 |
| Number Of Beneficiaries Age 65 to 74 | 50 |
| Number Of Beneficiaries Age 75 to 84 | |
| Number Of Beneficiaries Age Greater 84 | |
| Number Of Female Beneficiaries | 78 |
| Number Of Male Beneficiaries | 72 |
| Number Of Non Hispanic White Beneficiaries | 72 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 65 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 72 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 78 |
| Percent Of With Atrial Fibrillation | |
| Percent Of With Alzheimers Disease or Dementia | |
| Percent Of With Asthma | 11 |
| Percent Of With Cancer | |
| Percent Of With Heart Failure | 16 |
| Percent Of With Chronic Kidney Disease | 15 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 12 |
| Percent Of With Depression | 25 |
| Percent Of With Diabetes | 33 |
| Percent Of With Hyperlipidemia | 34 |
| Percent Of With Hypertension | 56 |
| Percent Of With Ischemic Heart Disease | 29 |
| Percent Of With Osteoporosis | |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 31 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 1.0659 |